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Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis01:25

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is based on...
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An Assay to Detect Protection of the Retinal Vasculature from Diabetes-Related Death in Mice
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Predicting the 20-year diabetes incidence rate.

Rachel Dankner1, Muhammad A Abdul-Ghani, Yariv Gerber

  • 1Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer, Israel. rachel@gertner.health.gov.il

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Predicting type 2 diabetes (T2DM) risk in older adults is crucial. Fasting glucose measurements are sufficient for long-term T2DM risk prediction, offering a simpler approach for elderly populations.

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Area of Science:

  • Endocrinology
  • Gerontology
  • Preventive Medicine

Background:

  • Long-range prediction of diabetes onset is vital for patient and clinical management.
  • Evaluating clinical glucose measurements for predicting type 2 diabetes (T2DM) risk in the elderly is important.

Purpose of the Study:

  • To assess the effectiveness of various glucose-related clinical measurements in predicting the 20-year risk of T2DM in an elderly cohort.
  • To compare the predictive capabilities of fasting glucose, post-oral glucose tolerance tests, and insulin levels.

Main Methods:

  • A prospective study followed 672 non-diabetic individuals (aged 59-92) for 20 years.
  • Fasting and post-load glucose, along with insulin, were measured at baseline and follow-up.
  • Statistical analyses included ROC analysis and adjusted logistic regressions.

Main Results:

  • 25.9% of participants developed T2DM over 20 years.
  • Fasting glucose was a strong predictor; a 100 mg/dL cutoff for impaired fasting glucose (IFG) increased sensitivity but decreased specificity.
  • 1-h post-load glucose showed similar predictive power to 2-h and fasting glucose.

Conclusions:

  • Fasting glucose alone is adequate for long-term T2DM risk prediction in the elderly.
  • Combining fasting and post-load glucose offers the best population-based diagnostic strategy for T2DM.
  • Individual glucose measurements significantly correlate with increased T2DM risk over two decades.